The Gift of Correctly Assessing Your Elder Loved Ones Needs

 

Happy Holiday’s From Reliant In-Home Care, LLC.!!

It’s not an easy transition when role reversals take place between children and aging parents. You’ve heard the saying ‘once a parent, always a parent’ or stronger yet, ‘once a mother, always a mother’. At some point in time it does become the adult child’s obligation to honor their parents by making sure they are safe and well taken for. By the time your Elderly parents have lived a full life accomplishing much, overcoming many obstacles, carving out and obtaining many dreams and goals, haven’t they become very strong and independent people! Especially if they have lived through a great depression or a world war like my parents, they are also very stoic and just don’t talk about their personal challenges with their children. If your parents live in a different city or state and most of your assessments are done over the phone, you might be surprised when you actually arrange a visit. I know when my husband used to call my mother in-law in Florida, she always said ‘everything is fine’, ‘I’m doing well’ until we received a call from a state social worker giving us the ultimatum that she either get 24 hour care stat or she was going into a nursing home immediately.  I’m not trying to scare you, the reality is that situations can change rapidly with the senior population and being prepared in advance is definitely the less stressful and preferable path.

I’d like to help you give the gift of being able to accurately assess your parent’s needs when you’re visiting with them for a few days. Keep in mind that the longer you’re with your parents the more opportunity you’ll have to see a complete picture emerge. Below is a useful checklist you can use as a guide to help determine if your elderly love one is still thriving living alone or if normal daily activities have become increasingly difficult to manage. There are many tall tell signs that will give you an accurate understanding of how your parents are doing. How best to communicate your findings to your parents and bring them on board with helpful strategies is another article in itself but for now, here’s how you can make an informed decision on whether it’s time to bring in a trained professional to make a formal assessment accompanied by specific advice on how to handle a given situation.

Here is a checklist that you can use as a guide:                                          

  • Do they appear poorly groomed — unshaven, hair dirty or unkempt or wearing dirty clothes when they always use to practice good hygiene and dressed well?
  •  Has your loved one lost weight?
  • Does their breath smell or do they have body odor?
  • Is there food in cabinets or the refrigerator; if so are they outdated or spoiled?
  • Are dishes piled in the sink, carpets dirty, furniture dusty?
  • Is the house cluttered and the yard a mess?
  • Have they lost interest in going out or in activities they once enjoyed?
  • Do they seem unsteady or afraid to use stairs?
  • Have you noticed changes in their normal behavior or routine?
  • Do they confuse easily, show signs of increased forgetfulness?
  • How do they handle going to the market or being in crowds?
  • If you trust the neighbors, do they have any insight on how your parent is doing?
  • Are there piles of mail unopened, how are bills being handled?

How is your Mom or Dad performing these basic Activities of Daily Living?

Bathing – including the ability to get in and out of a shower or tub
Eating – including the ability to cut food or butter bread
Dressing – including the ability to choose appropriate attire
Toileting – including the ability to transfer on and off the toilet
Transferring – the ability to get in and out of bed or a chair

How is your Mom or Dad performing these basic Instrumental Activities of Daily Living?

Cleaning, Preparing meals, Taking medication                                                      
Doing laundry
Performing yard work
Bill paying/banking
Walking outside the home
Driving
Shopping
Using the telephone

Enjoy your time with family this Holiday Season and please be aware to evaluate how your elderly parents, grandparents or neighbors are doing. They often won’t admit that they need assistance to continue living and aging gracefully. Your reaching out and observing might make all the difference. You can always give us a call at Reliant In-Home Care, we are happy to assist or be a good resource for any senior care needs.

www.Reliantinhomecare.com

                                                Serving San Diego Since 2005!

Assessing An Aging Adults Needs

 

It’s not an easy transition when role reversals take place between children and aging parents. You’ve heard the saying ‘once a parent, always a parent’ or stronger yet, ‘once a mother, always a mother’. At some point in time it does become the adult child’s obligation to honor their parents by making sure they are safe and well taken for. By the time your Elderly parents have lived a full life accomplishing much, overcoming many obstacles, carving out and obtaining many dreams and goals, haven’t they become very strong and independent people! Especially if they have lived through a great depression or a world war like my parents, they are also very stoic and just don’t talk about their personal challenges with their children. If your parents live in a different city or state and most of your assessments are done over the phone, you might be surprised when you actually arrange a visit. I know when my husband used to call my mother in-law in Florida, she always said ‘everything is fine’, ‘I’m doing well’ until we received a call from a state social worker giving us the ultimatum that she either get 24 hour care stat or she was going into a nursing home immediately.  I’m not trying to scare you but highlighting the fact that being proactive and prepared to manage the changing needs of your elderly parents, is always less stressful than having to put out fires during crisis.

I’d like to help you give the gift to yourself and your aging parent, of being able to accurately assess how your parent is really doing living alone, when you’re visiting with them this summer for a few days. Keep in mind that the longer you’re with your parents the more opportunity you’ll have to see a complete picture emerge. Below is a useful checklist you can use as a guide to help determine if your elderly love one is still thriving living alone or if normal daily activities have become increasingly difficult to manage. There are many tall tell signs that will give you an accurate understanding of how your parents are doing. How best to communicate your findings to your parents and bring them on board with helpful strategies such as a professional caregiver, home modifications, a church volunteer visit, meals on wheels etc. Our trained professionals at Reliant In-Home Care are always available for a free ‘Home Assessment’ to help you make an informed decision on whether it’s time to consider bringing in some assistance for a few hours a day, or merely get some specific advice on ways to remedy the specific areas of challenge your parent is facing.

 

Here is a checklist that you can use as a guide:

  • Does your loved one appear poorly groomed — unshaven, hair dirty or unkempt or wearing dirty clothes when they always use to practice good hygiene and dressed well?
  •  Has your loved one lost weight?
  • Does their breath smell or do they have body odor?
  • Is there food in cabinets or the refrigerator; if so are they outdated or spoiled?
  • Are dishes piled in the sink, carpets dirty, furniture dusty?
  • Is the house cluttered and the yard a mess?
  • Have they lost interest in going out or in activities they once enjoyed?
  • Do they seem unsteady or afraid to use stairs?
  • Have you noticed changes in their normal behavior or routine?
  • Do they confuse easily, show signs of increased forgetfulness?
  • How do they handle going to the market or being in crowds?
  • If you trust the neighbors, do they have any insight on how your parent is doing?
  • Are there piles of mail unopened, how are bills being handled?

How is your Mom or Dad performing these basic Activities of Daily Living?

Bathing – including the ability to get in and out of a shower or tub
Eating – including the ability to cut food or butter bread
Dressing – including the ability to choose appropriate attire
Toileting – including the ability to transfer on and off the toilet
Transferring – the ability to get in and out of bed or a chair

 

How is performing these basic Instrumental Activities of Daily Living Going?

  1. Cleaning 
  2. Preparing meals
  3. Taking medication
  4. Doing laundry
  5. Performing yard work
  6. Bill paying/banking
  7. Walking outside the home
  8. Driving
  9. Shopping
  10. Using the telephone

Aging in place is the preferable choice for the majority of aging adults. Often it requires just a few changes to make it possible for a loved one to be supported and assisted in the comfort and familiarity of their own home. With all the resources available today it is a very viable option!  If you have any questions about the Long Term Care Plans for your aging adult, please give us a call at Reliant In-Home Care. We are happy to be a resource to help you navigate the realms of elder care.

 

Evolving World of Long Term Care

Being in the Long Term Care industry for older adults is a ever evolving and expanding field. A large contributor toward the speed of this evolution is due to the tsunami of Baby Boomers entering retirement. Seventy-six million American children were born between 1945 and 1964, this makes up almost 40% of the United States population. This particular cohort is hugely significant because of it’s size alone! ‘Baby Boomer’ has become the buzz word in the fields of economics, medical science & health, politics, technology, and architecture to name a few. I thought I would share a few developments that I personally find interesting and that are influencing the industry Reliant In-Home Care, LLC is part of.

Technology to help older adults age in place has gone far beyond fall-alert buttons and grab bars. Today, a host of sophisticated products are available on the market, including medication dispensers that can report to a family member when their loved one forgets to take a pill and shoes with embedded GPS trackers to find cognitively impaired wanderers.

  

My grandmother Ruth was practically deaf at 99 years of age and having a enhanced phone was a great success in helping her to keep connected with us long distanced grandchildren! California Telephone Access Program offers free specialized phones that make it easier to hear, dial, and easier to call. It’s also free to those who qualify!

One of the medical science advancements that can greatly decrease hospital re-admissions is the newly FDA approved ‘Digital Pill’.  Re-admissions to the hospital for older adults puts a huge burden on the Medicare system, this new development is designed to help remedy the confusion regarding proper medication compliance.

Studies have shown that 70% of Americans will require long-term care services, writes U.S. News, and as most long-term care is paid for by Medicaid, a swelling boomer population could end up swamping the program in the years to come. A research study done by Fidelity showed that nearly 4 in 10 retiree households do not have sufficient income to cover their monthly expenses. Stats say that half of all Americans have less than $25,000 in total savings, this is not including the value of their primary residence or pension plans. One solution for funding Long Term Care that is gaining popularity is the Home Equity Conversion Mortgage (HECM Reverse Mortgage.) This is the only reverse mortgage insured by the U.S. Federal Government. According to research by the American Association of Retired Persons, 90% of seniors want to stay in their own homes as they age. HECM is a very viable option to ‘Use Your Home To Stay At Home’. I will be speaking about In-Home Care along with a Reverse Mortgage specialist on May 30. *Please tune in to: Real Estate Radio @ ESPN 1700 AM Thursdays 1-2PM with David McElveen to hear more about home care and optional funding!

This is an exciting time in the history of caring and providing for older adults. It’s not just about living longer but innovating new ways to assist baby boomers to thrive as we enter retirement and beyond. For skilled and compassionate home care solutions, let your friends, associates and family know that they can rely on Reliant In-Home Care to assist them in the evolving world of long term care.

 

Transforming Healthcare Through Technology

For healthcare professionals and the general population, —we are at the cusp of a renaissance in healthcare. Technology—including the Internet of Everything (IoE), robotics, 3-D printing, wearable technology, cloud, mobility, and many others—promises to usher in this new era in healthcare. In short, the best is yet to come!

Here are a couple of examples that will transform healthcare over the next 10 years:

1) Scaling expertise to broaden quality care: One of the challenges of healthcare today is that expertise is often contained in a fixed location or individual person. For example, a surgeon who has become an expert in performing a challenging, life-saving operation can be in only one place at a time. In the future, the combination of video, robotics, sensing, gesture recognition, and IoE will allow surgeons to perform operations at specially equipped, remote locations.

Imagine this doctor being able to perform specialized surgeries at specially equipped operation rooms around the world from a fixed location.

While Intuitive Surgical greatly improved patient outcomes with its ultra-precise robotic machines, one of the barriers to performing remote operations has been the lack of sensory feedback from robotic systems. Imagine using your hands to perform a complex operation if your fingers can’t feel pressure, temperature, and other sensations. Just recently, the FDA approved the first bionic hand that allows amputees to feel the sense of touch. This same technology, for instance, could be applied to a glove that allows surgeons to feel the remote surgery as if they were there in person.

2) Your patients…only better: Advances in 3-D printing are creating realistic-looking, anatomically correct and functional ears for patients. The ears are created by squirting (like an inkjet printer) living cells into an injection mold. In just three months, each ear grows cartilage in the shape of the mold. According to medical researchers and surgeons, the ersatz ears could soon replace the ears of children with congenital deformities or be used to reconstruct ears that have been damaged due to accidents. When it comes to sight, the FDA just approved Argus II, the first prosthesis to restore limited vision to patients blinded by retinitis pigmentosa. Meanwhile, researchers at Duke University have equipped rats with implanted sensors that enable them to see and respond to infrared light (normally invisible to human and rodent eyes). Could this technology help the blind to see?

Another important change is that healthcare will become more of an ongoing process in our daily lives rather than a series of static events when we need care. For example, imagine receiving a mini-checkup from your bathroom mirror every time you brush your teeth. Virtual reality, smart surfaces, cloud computing, gesture recognition, and new sensing advances like Eulerian Video Magnification can literally measure vital signs such as your heartbeat. This, and other information about your health could then be sent to your personal physician. Using resources such as advanced analytics and IBM’s Watson in the cloud, your doctor could be alerted to any issues that need to be addressed.

While technology will play a critical role in transforming healthcare, real and lasting change will come from people who have the passion to make a difference. Just as in the original Renaissance, all of the components for change are present (in this case, science, technology, physics, networks, and communications). It is now up to us to bring the pieces together to usher in the new era of healthcare.

*Material taken from: This blog was co-authored by Dave Evans and Joseph Bradley, Cisco Internet Business Solutions Group (IBSG).

Reducing Hospital Readmissions

One of the leading topics in healthcare today is reducing hospital readmission rates.  The National Institute of Health Care Reform’s 2011 report “Physician Visits after Hospital Discharge: Implications for Reducing Readmissions” found that the cost of hospital readmissions is $97 billion annually, $27 billion of which are Medicare expenditures according to Academy Health.

Nearly 1-in-5 seniors who are hospitalized return to the hospital within 30 days. When seniors are readmitted repeatedly for the same ailment, it may indicate a need for the kind of ongoing care and support available at assisted living communities or the home care support

Reforms and Patient Education

New rules passed as part of Patient Protection and Affordable Care Act aim to reduce the need for readmissions by charging additional fees to hospitals with excessive readmissions. Although it’s still early, this policy seems to have had an effect. A recent New York Times article outlined the efforts of hospitals across the country that have seen success in reducing hospital readmissions by adopting changes to discharge planning including:

  • Identifying patients who are at highest risk of readmission
  • Follow-up nurse visits to patients’ homes
  • Transportation to for patient follow-up appointments
  • Pro-actively ordering patient prescriptions and scheduling follow-ups
  • Patient and caregiver education
  • Culturally specific diet tips
  • Increased monitoring of nursing home patients

In our 8 years of working with families, we’ve found that hospital readmissions for senior patients are indicative of a need for ongoing care and support – the type of support that assisted living communities or home care agencies can provide. For example, seniors who live alone or who do not have adequate support may have difficulty adhering to recommendations regarding self-care, proper diet with hydration and medication administration. Transportation to follow up visits can also be an issue for seniors, particularly for those who don’t drive.

Seniors who have in-home caregiving support receive a number of services that can help keep them healthy and out of the hospital:

  • A formalized care plan
  • Medication management
  • Ongoing monitoring of health and well-being
  • Transportation to scheduled medical appointments
  • Nutritional meals
  • Socialization & stimulating activities
  • Appropriate exercise

If you are in a relationship with a family who needs assistance who is challenged by the responsibility of caring for a elder loved one, we can help. Contact Reliant In-Home Care for more information and a free care assessment.

VA Pension (Aid & Attendance)

The new VA Pension amounts have been released and I wanted to pass them on to you.The 2013 maximum Aid and Attendance amounts are:

Married Veteran: $2054 a month

Single Veteran: $1732 a month

Surviving Spouse of a Veteran: $1113 a month

(tax-free income dropped into their account just like their Social Security check)

What is the VA Improved Pension?
The VA Improved Pension was established to provide financial assistance to veterans and their spouses. It allows them to live their lives in dignity and afford basic necessities.
This benefit is NOT dependent upon service-related injuries. It helps cover the cost of qualified unreimbursed medical expenses for in-home, assisted living, and skilled nursing care. Though the pension has been in existence for decades, most veterans and their families have never heard about it, or have not been given guidance on how to qualify.

What is the Basic Criteria for Qualifying?

  • Veteran must have served at least one (1) day during a qualified war period
  • Veteran must have served at least ninety (90) days of active duty prior to 1980 (24 months post-1980)
  •  Veteran did not receive dishonorable discharge
  • Claimant is over age of 65 or permanently or totally disabled and non-employable.
  •  Claimant is a surviving spouse of a qualified veteran and has not remarried
  • Claimant or spouse needs assistance with daily living requirements.

Claimant’s monthly un-reimbursed care expenses equal or exceed their monthly income.

(ADL’s include; dressing, bathing, grooming, personal hygiene, incontinence, medication management, & transferring)

This monthly benefit can be used to help fund home care assistance making it possible for those whom normally would be unable to afford it. If you know of someone who’d like to see if they are eligible, please give our office a call and we can refer you to a specialist who can help!

2013 is Named the Year of Elder Abuse Prevention

Aside

It is not something most of us want to think about. But according to the U.S. Administration on Aging (AoA), each year an estimated 2.1 million older Americans are victims of elder abuse, neglect or exploitation. And that’s only part of the picture: Experts believe that for every case of elder abuse or neglect reported, as many as five cases go unreported. Elder abuse takes many forms, including financial exploitation, physical abuse, neglect, and emotional abuse. The Year of Elder Abuse Prevention is an opportunity for Americans to take action to protect seniors by raising awareness about this serious issue.

As the AoA suggests here are 10 things that anyone can do to help prevent elder abuse:

Learn the signs of elder abuse and neglect.

  1. Call or visit elderly relatives, friends, and neighbors and ask how they are doing.
  2. Provide a respite for a caregiver by filling in for a few hours or more.
  3. Ask an older acquaintance to share his or her talents by teaching you or your          children  new skill.
  4. Ask your faith leaders to discuss with their congregations elder abuse prevention     and the importance of respecting older adults.
  5. Ask your bank manager to train tellers on how to detect financial exploitation of   elders.
  6. Suggest your doctor talk to his or her older patients individually about possible abuse.
  7. Contact your local adult protective services or long-term care ombudsman to learn  how to support their work helping at-risk elders
  8. Volunteer to be a friendly visitor to a nursing home resident or home-bound elder in   your community.
  9. Send a letter to your local paper, radio, or TV station suggesting it cover World Elder Abuse Awareness Day or National Grandparents Day.
  10. Learn what the signs are of Elder abuse

To learn the signs of elder abuse and neglect. Visit the National Center on Elder Abuse website (www.ncea.aoa.gov) for more resources and information about preventing and raising the awareness of elder abuse. Or call 1-855-500-3537.

Preventing Seniors Returning to the Hospital

The Agency for Healthcare Research and Quality (AHRQ) offers information to help patients safely transition after hospital care.

According to the U.S. government, one-fifth of patients covered by Medicare return to the hospital within 30 days. The AHRQ tells us that these re-admissions cost about $17 billion each year. Re-admissions can also slow down a patient’s recovery.

As of October, Medicare’s reimbursement rate will reflect the ability of hospitals to prevent unnecessary re-hospitalizations. Hospitals with high readmission rates for heart attack, pneumonia and heart failure are now paid less than those with fewer re-admissions.

Older patients are at higher risk of returning to the hospital because they are more likely to be frail and have chronic conditions. Other reasons are more avoidable: Older patients may need help with transportation to follow-up appointments. And they may need extra support when leaving the hospital for home, or when transitioning to a skilled nursing facility.

AHRQ has developed a new guide for patients: Taking Care of Myself: A Guide for When I Leave the Hospital, an easy-to-understand plan for what to do when you or a loved one leaves the hospital. The guide can be used by both hospital staff and patients during the discharge process, and provides a way for patients to track their medication schedules, upcoming medical appointments, and important phone numbers. You can download a free copy of the guide on the AHRQ website or order a copy to be sent to your home.

The AHRQ’s Dr. Carolyn Clancy says, “Helping patients improve their health once they leave the hospital is not easy or automatic. The new effort by hospitals to prevent re-admissions is a big step in the right direction. You can help by learning what you should do when you or your loved ones are in the hospital.”

People With Diabetes Should Take Extra Care During Hot Weather

Extreme heat is especially dangerous to people age 65 and older and people with chronic diseases such as diabetes. If you have diabetes, it is harder for your body to handle high heat and humidity. You may need to make changes in your medication and what you eat and drink when temperatures heat up.

Hot weather – temperatures of 80°F (about 27°C) or above, especially with high humidity – can affect medication, testing supplies and your health. The heat index, which measures how hot it really feels by combining temperature and humidity readings, advises caution starting at 80°F with 40% humidity. The Centers for Disease Control and Prevention (CDC) offers these tips:

  • Heat can affect your blood sugar (glucose) levels and also increase the absorption of some fast-acting insulin, meaning you will need to test your blood sugar more often and perhaps adjust your intake of insulin, food, and liquids.
  • Drink plenty of fluids, especially water, to avoid dehydration. Don’t wait until you get thirsty; it’s a sign you’re already dehydrated. Avoid sugar-sweetened drinks such as sweet tea and sodas.
  • If your doctor has limited how much liquid you can drink, ask what to do during times of high heat.
  • Know the signs of heat-related illness and how to respond to symptoms of heat exhaustion and heat stroke. Heat stroke can cause death or permanent disability if emergency treatment is not provided.
  • Wear sunscreen and use a lip balm with sunscreen.
  • Wear loose-fitting, lightweight, and light-colored clothing.
  •  Check package inserts with medications to learn when high temperatures can affect them. Take medications with you if you will need to take them while you’re away from home, and protect them from the heat.
  • If you’re traveling with insulin, don’t store it in direct sunlight or in a hot car. Keep it in a cooler, but do not place it directly on ice or on a gel pack.
  • Check glucose meter and test strip packages for information on use during times of high heat and humidity. Do not leave them in a hot car, by a pool, or on the beach.
  • Heat can damage insulin pumps and other equipment. Do not leave the disconnected pump or supplies in the direct sun or in a hot car.
  • Get physical activity in air-conditioned areas, or exercise outside early or late in the day, during cooler temperatures.
  • Use your air conditioner or go to air-conditioned buildings in your community.

Understanding Your Senior Living Options

In the old days, older adults who needed care usually moved in with adult children, or to what was then called a “rest home.” But today, senior living communities provide a wide variety of senior housing and support options. How do you sort through the maze of choices and make the best decision?

“Is it time to move?” Most older adults ask themselves this question many times before they make the final decision. If you or a senior loved one is looking into the options, it may seem overwhelming—especially if a sudden health crisis forces the decision faster than you expected.

The decision about where to live can make a huge difference in quality of life and well-being for seniors and family alike. Today there are more senior living options to choose from than ever before. Here is an overview of retirement housing choices:

Senior Housing refers to any type of housing limited to people over a certain age.  It may be subsidized for lower-income seniors. The emphasis is on independent living, with few, if any, services offered.

Retirement Living Communities offer independent senior living in apartments, town homes or detached homes. They serve seniors who are generally in good health and do not provide personal care or health assistance. Many offer services such as housekeeping, dining, transportation and activities.

Continuing Care Retirement Communities (CCRCs) offer a full range of care, ranging from independent living to assisted living to skilled nursing care, all in one complex or “campus.” Some CCRCs charge a straight monthly rental. Others require an up-front “buy in.”

Assisted Living usually includes a private apartment and services which include help with personal care needs, some health care services, housekeeping and a recreation program.

Adult Family Homes are single-family homes licensed by the state to provide room, board and support services, on a short-term or long-term basis.

Skilled Nursing Facilities (nursing homes) provide extended care for frail or chronically ill seniors who require a high level of skilled nursing care and medical supervision.

Services for Aging in Place

Many seniors want to stay in the comfort and independence of their own home, apartment or condo, even as their health needs change. Support services for these seniors include home modifications, home-delivered meals, senior transportation, adult day centers, and in-home care. Home care services include housekeeping, meal preparation, transportation, and personal care, such as help with bathing and grooming. Home health care, provided by nurses or aides, ranges from simple medical procedures, all the way to skilled medical services and rehabilitation services in the home.

Rules of Thumb for the Savvy Senior Living Shopper

  1. Begin the search early and take your time.
  2. Get the facts you need to make an informed decision.
  3. Begin with a realistic evaluation of your needs—both current and looking to the future.
  4. Visit potential senior living communities and talk to current residents.
  5. Don’t make the decision alone. Talk it over with family and professionals (your doctor, financial adviser, geriatric ).